Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | D0052173 | MD |
NPI | 1346390234 |
---|---|
Provider Name | Dr. Ndidi Nnalu Nwokorie |
First Address | Woodstock, MD 21163-1019 |
Second Address | Baltimore, MD 21237-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 29/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
75859901 | BLUE SHIELD (01) | MD |
F72316 | (02) | MD |